| NPI | 1972037851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 902240) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902240) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-10-25 |